Healthcare Provider Details

I. General information

NPI: 1427346329
Provider Name (Legal Business Name): STEPHANIE DENISE CRUME LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1719 SW 11TH ST
LAWTON OK
73501-7305
US

IV. Provider business mailing address

112 W MAIN ST
PURCELL OK
73080-4220
US

V. Phone/Fax

Practice location:
  • Phone: 580-581-1818
  • Fax: 580-581-1819
Mailing address:
  • Phone: 405-527-1785
  • Fax: 405-527-1084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5328
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: